The effects of ropivacaine hydrochloride on platelet function: an assessment using the platelet function analyser (PFA-100).

Abstract:

:Amide local anaesthetics impair blood clotting in a concentration-dependent manner by inhibition of platelet function and enhanced fibrinolysis. We hypothesised that the presence of ropivacaine in the epidural space could decrease the efficacy of an epidural blood patch, as this technique requires that the injected blood can clot in order to be effective. Ropivacaine is an aminoamide local anaesthetic used increasingly for epidural analgesia during labour. The concentration of local anaesthetic in blood achieved in the epidural space during the performance of an epidural blood patch is likely to be the greatest which occurs (intentionally) in any clinical setting. This study was undertaken to investigate whether concentrations of ropivacaine in blood, which could occur: (i) clinically in the epidural space and (ii) in plasma during an epidural infusion of ropivacaine, alter platelet function. A platelet function analyser (Dade PFA-100, Miami) was employed to assess the effects of ropivacaine-treated blood on platelet function. The greater concentrations of ropivacaine studied (3.75 and 1.88 mg x ml(-1)), which correspond to those which could occur in the epidural space, produced significant inhibition of platelet aggregation. We conclude that the presence of ropivacaine in the epidural space may decrease the efficacy of an early or prophylactic epidural blood patch.

journal_name

Anaesthesia

journal_title

Anaesthesia

authors

Porter J,Crowe B,Cahill M,Shorten G

doi

10.1046/j.1365-2044.2001.01760.x

subject

Has Abstract

pub_date

2001-01-01 00:00:00

pages

15-8

issue

1

eissn

0003-2409

issn

1365-2044

pii

ana1760

journal_volume

56

pub_type

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